The West Windsor Plainsboro Soccer Association Travel Program (WWPSA TRAVEL) recognizes that concussions and head injuries are commonly reported injuries in children and adolescents who participate in sports and recreational activity and can have serious consequences if not managed carefully. Therefore, WWPSA TRAVEL has adopted the following policy to support the proper evaluation and management of head injuries.
A concussion is a mild traumatic brain injury. A concussion occurs when normal brain functioning is disrupted by a blow or jolt to the head. Recovery from concussion will vary. Avoiding re-injury and over-exertion until fully recovered are the cornerstones of proper concussion management.
While trainers and/or coaches will exercise reasonable care to protect players, head injuries may still occur. Trainers and coaches will be required to complete training to recognize the signs, symptoms and behaviors consistent with a concussion. Any player exhibiting those signs, symptoms or behaviors while participating in a WWPSA TRAVEL practice or game shall be removed from the game or practice. Where possible, the player should be taken from the facility by his/her parents. The trainer/coach will notify the player’s parents or guardians if they are not at the activity so they may take appropriate action.
The player who suffers a concussion (whether in a WWPSA TRAVEL sponsored activity or any other non-WWPSA TRAVEL activity) may not return to practice or games until she/he has been evaluated by an appropriate health care professional (e.g., licensed physician, nurse practitioner or physician assistant) and provides to WWPSA TRAVEL written authorization from the treating health care professional permitting the player to return to full soccer activities. Any player who has signs or symptoms upon return to practice or games will be removed from play and may be required to undergo a reevaluation by their health care professional. WWPSA TRAVEL reserves the right to require any player suspected of a possible concussion to provide written authorization to return to play from his/her treating health care professional.
If a player sustains a concussion at a time other than when engaged in a WWPSA TRAVEL sponsored activity or where the symptoms manifested themselves after a WWPSA TRAVEL sponsored activity, WWPSA TRAVEL requires the parent/guardian to report the condition to the trainer/coach so that WWPSA TRAVEL can be aware of the condition.
- It is extremely important that all players be made aware of the importance of reporting any symptoms of a concussion to their parent/guardian and/or trainer/coach;
- Informing their trainer/coach, parent/guardian, about injuries and the symptoms they are experiencing;
- Following the instructions from their health care professional; and
- Encouraging teammates to report injuries.
- Report to the trainer/coach any concussion sustained by his/her player outside a WWPSA TRAVEL activity or where the symptoms manifested themselves after a WWPSA TRAVEL activity;
- Obtain an written authorization from the player’s treating health care professional clearing the player to return to soccer activities and provide a copy of the authorization to WWPSA TRAVEL;
- Manage the return to play progression protocol assigned by the player’s treating health care professional; and
- Promoting an environment where reporting signs and symptoms of a concussion is considered acceptable.
Parent, guardians, and players are strongly encouraged to undertake training on concussions that includes information on the symptoms of a concussion. The Center for Disease Control (“CDC”) provides information on concussions, including free web-based training - Heads Up: Concussion in Youth Sports. It is available at http://www.cdc.gov/concussion/HeadsUp/online_training.html. Parents/Guardians are also encouraged to will have a baseline SCAT (Standardized Concussion Assessment Tool) or Impact Assessment Tool evaluation performed on their player each year to establish a baseline should the player sustain a concussion.
Return to Play Progression
Generally, return to play following a concussion involves a stepwise progression once the individual is symptom free for at least 24 hours. A player’s treating health care professional will likely establish progression for the player based on their medical evaluation. The following is one such possible return to play progression protocol based on the Zurich Progressive Exertion Protocol that the player’s treating health care professional may follow (click here for link to original source):
Phase 1 - low impact, non-strenuous, light aerobic activity such as walking or riding a stationary bike. If tolerated without return of symptoms over a 24 hour period proceed to;
Phase 2 – higher impact, higher exertion, and moderate aerobic activity such as running or jumping rope. No resistance training. If tolerated without return of symptoms over a 24 hour period proceed to;
Phase 3 – Sport specific non-contact activity. Low resistance weight training with a spotter. If tolerated without return of symptoms over a 24 hour period proceed to;
Phase 4 – Sport specific activity, non-contact drills. Higher resistance weight training with a spotter. If tolerated without return of symptoms over a 24 hour period proceed to;
Phase 5 – Full contact training drills and intense aerobic activity. If tolerated without return of symptoms over a 24 hour period proceed to
Phase 6 – Return to full activities without restrictions.
Each step should take 24 hours, so the player would take approximately one week to proceed through the full rehabilitation protocol once she/he is asymptomatic at rest and with provocative exercise. If any post-concussion symptoms occur while in the stepwise program, then the player should drop back to the previous asymptomatic level and try to progress again after a further 24-hour period of rest has passed. If a player is not progressing or there is an indication of a more serious head injury, the Parent or Guardian should consult with her/his player’s treating clinician.
Concussion Signs and Symptoms
- Neck pain
- Lack of energy and constantly feeling physically and mentally tired
- Dizziness, light-headedness, and a loss of balance
- Blurred or double vision and sensitivity to light
- Increased sensitivity to sounds
- Ringing in the ears
- Loss of sense of taste and smell
- Change in sleep patterns especially waking up a lot at night
- Difficulty concentrating and paying attention
- Trouble with learning and memory
- Problems with word-finding and putting thoughts into words
- Easily confused and losing track of time and place
- Slower in thinking, acting, reading, and speaking
- Easily distracted
- Trouble doing more than one thing at a time
- Lack of organization in everyday tasks
Social and Emotional Symptoms
- Mood changes including irritability, anxiousness, and tearfulness
- Decreased motivation
- Easily overwhelmed
- More impulsive
- Withdrawn and wanting to avoid social situations especially if there is a lot of people